Provider Demographics
NPI:1154059772
Name:PETERS, CHRISTIAN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:
Last Name:PETERS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3918 MONTCLAIR RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2417
Mailing Address - Country:US
Mailing Address - Phone:205-761-1068
Mailing Address - Fax:205-719-4158
Practice Address - Street 1:3918 MONTCLAIR RD STE 101
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35213-2417
Practice Address - Country:US
Practice Address - Phone:205-761-1068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH10962225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist